nach oben

Sleep and Breathing

Erschienen in:

30.06.2023 | Sleep Breathing Physiology and Disorders • Original Article

Comorbidities are associated with self-reported sleep-disordered breathing and insomnia: a cross-sectional study from China

verfasst von: Shengnan Li, Siyue Tan, Dong Liu, Ke Zhang, Yuyi Zhang, Bo Wang, Hui Zuo

Erschienen in: Sleep and Breathing | Ausgabe 6/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We aimed to examine the associations of comorbidities with self-reported sleep-disordered breathing (SDB) and insomnia among Chinese adults.

Methods

The study used data from a community-based cross-sectional survey performed in China in 2018–2020. Multivariable logistic regression models were used to analyze the associations of 12 comorbidities with SDB and insomnia.

Results

A total of 4329 Han Chinese adults aged ≥ 18 years were enrolled. Of these, 1970 (45.5%) were male, with a median age of 48 years (interquartile range: 34–59). Compared with the participants without any conditions, adjusted ORs for SDB and insomnia for those with ≥ 4 comorbidities were 2.33 (95% CI: 1.58, 3.43, P-trend < 0.001) and 3.89 (95% CI: 2.69, 5.64, P-trend < 0.001), respectively. Seven comorbidities (hypertension, hyperlipidemia, coronary heart disease (CHD), bone and joint disease, neck or lumbar disease, chronic digestive diseases, and chronic urological disease) were positively associated with both SDB and insomnia. Cancer and chronic obstructive pulmonary disease (COPD) were also independently associated with insomnia. Of all comorbidities, cancer was most strongly associated with insomnia (OR = 3.16; 95% CI: 1.78, 5.63; P < 0.001), and CHD was most strongly associated with SDB (OR = 1.77; 95% CI: 1.19, 2.64; P < 0.001).

Conclusions

The findings showed that adults with an increasing number of comorbidities had higher odds for SDB and insomnia, which were independent of sociodemographic and lifestyle factors.

Benjafield AV, Ayas NT, Eastwood PR et al (2019) Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 7:687–698. https://doi.org/10.1016/S2213-2600(19)30198-5CrossRefPubMedPubMedCentral

Kay-Stacey M, Attarian H (2016) Advances in the management of chronic insomnia. BMJ 354:i2123. https://doi.org/10.1136/bmj.i2123CrossRefPubMed

Li X, Sotres-Alvarez D, Gallo LC et al (2021) Associations of sleep-disordered breathing and insomnia with incident hypertension and diabetes. The Hispanic community health study/study of Latinos. Am J Respir Crit Care Med 203:356–365. https://doi.org/10.1164/rccm.201912-2330OCCrossRefPubMedPubMedCentral

Troxel WM, Buysse DJ, Matthews KA et al (2010) Sleep symptoms predict the development of the metabolic syndrome. Sleep 33:1633–1640. https://doi.org/10.1093/sleep/33.12.1633CrossRefPubMedPubMedCentral

Chan MTV, Wang CY, Seet E et al (2019) Association of unrecognized obstructive sleep apnea with postoperative cardiovascular events in patients undergoing major noncardiac surgery. JAMA 321:1788–1798. https://doi.org/10.1001/jama.2019.4783CrossRefPubMedPubMedCentral

Heinzer R, Vat S, Marques-Vidal P et al (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318. https://doi.org/10.1016/S2213-2600(15)00043-0CrossRefPubMedPubMedCentral

Léger D, Morin CM, Uchiyama M et al (2012) Chronic insomnia, quality-of-life, and utility scores: comparison with good sleepers in a cross-sectional international survey. Sleep Med 13:43–51. https://doi.org/10.1016/j.sleep.2011.03.020CrossRefPubMed

Bertisch SM, Pollock BD, Mittleman MA, et al (2018) Insomnia with objective short sleep duration and risk of incident cardiovascular disease and all-cause mortality: sleep heart health study. Sleep 41. https://doi.org/10.1093/sleep/zsy047

Gottlieb DJ, Punjabi NM (2020) Diagnosis and management of obstructive sleep apnea: a review. JAMA 323:1389–1400. https://doi.org/10.1001/jama.2020.3514CrossRefPubMed

10.

Wickwire EM, Shaya FT, Scharf SM (2016) Health economics of insomnia treatments: The return on investment for a good night’s sleep. Sleep Med Rev 30:72–82. https://doi.org/10.1016/j.smrv.2015.11.004CrossRefPubMed

11.

Singer RB, Milano AF (2007) Mortality in co-morbidity (I)–analysis of the results in the multiple medical impairment study for impairments with elevated blood pressure as the second or co-morbid impairment. J Insur Med 39:78–88PubMed

12.

Mokhlesi B, Ham SA, Gozal D (2016) The effect of sex and age on the comorbidity burden of OSA: an observational analysis from a large nationwide US health claims database. Eur Respir J 47:1162–1169. https://doi.org/10.1183/13993003.01618-2015CrossRefPubMed

13.

Taylor DJ, Mallory LJ, Lichstein KL et al (2007) Comorbidity of chronic insomnia with medical problems. Sleep 30:213–218. https://doi.org/10.1093/sleep/30.2.213CrossRefPubMed

14.

Senaratna CV, English DR, Currier D et al (2016) Sleep apnoea in Australian men: disease burden, co-morbidities, and correlates from the Australian longitudinal study on male health. BMC Public Health 16:1029. https://doi.org/10.1186/s12889-016-3703-8CrossRefPubMed

15.

Lechat B, Appleton S, Melaku YA et al (2022) Comorbid insomnia and sleep apnoea is associated with all-cause mortality. Eur Respir J 60:2101958. https://doi.org/10.1183/13993003.01958-2021CrossRefPubMed

16.

Ruel G, Martin SA, Lévesque J-F et al (2018) Association between multimorbidity and undiagnosed obstructive sleep apnea severity and their impact on quality of life in men over 40 years old. Glob Health Epidemiol Genom 3:e10. https://doi.org/10.1017/gheg.2018.9CrossRefPubMedPubMedCentral

17.

Robichaud-Hallé L, Beaudry M, Fortin M (2012) Obstructive sleep apnea and multimorbidity. BMC Pulm Med 12:60. https://doi.org/10.1186/1471-2466-12-60CrossRefPubMedPubMedCentral

18.

Dikeos D, Georgantopoulos G (2011) Medical comorbidity of sleep disorders. Curr Opin Psychiatry 24:346–354. https://doi.org/10.1097/YCO.0b013e3283473375CrossRefPubMed

19.

Koyanagi A, Garin N, Olaya B et al (2014) Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study. PLoS One 9:e114742. https://doi.org/10.1371/journal.pone.0114742CrossRefPubMedPubMedCentral

20.

Kyprianidou M, Panagiotakos D, Kambanaros M et al (2021) Quality of sleep in the Cypriot population and its association with multimorbidity: a cross-sectional study. Front Public Health 9:693332. https://doi.org/10.3389/fpubh.2021.693332CrossRefPubMedPubMedCentral

21.

Yao S-S, Cao G-Y, Han L et al (2020) Prevalence and patterns of multimorbidity in a nationally representative sample of older chinese: results from the china health and retirement longitudinal study. J Gerontol a Biol Sci Med Sci 75:1974–1980. https://doi.org/10.1093/gerona/glz185CrossRefPubMed

22.

Lin Y, Hu Y, Guo J et al (2022) Association between sleep and multimorbidity in Chinese elderly: Results from the Chinese longitudinal healthy longevity survey (CLHLS). Sleep Med 98:1–8. https://doi.org/10.1016/j.sleep.2022.06.007CrossRefPubMed

23.

Wang Y-M, Song M, Wang R et al (2017) Insomnia and multimorbidity in the community elderly in China. J Clin Sleep Med 13:591–597. https://doi.org/10.5664/jcsm.6550CrossRefPubMedPubMedCentral

24.

Wang C, Wang B, Liu D et al (2022) Self-reported sleep-disordered breathing and insomnia in association with hypertension: a community-based study in Eastern China. Blood Press Monit 27:320–326. https://doi.org/10.1097/MBP.0000000000000609CrossRefPubMed

25.

Wang C, Zheng Y, Zhang Y et al (2022) Dietary patterns in association with hypertension: a community-based study in Eastern China. Front Nutr 9:926390. https://doi.org/10.3389/fnut.2022.926390CrossRefPubMedPubMedCentral

26.

Li S, Wang C, Tan S, et al (2023) Association of dietary approaches to stop hypertension (dash) diet with self-reported sleep-disordered breathing (SDB): a cross- sectional study from China. Br J Nutr 1–23. https://doi.org/10.1017/S0007114523000880

27.

Chen G-C, Koh W-P, Yuan J-M et al (2018) Green leafy and cruciferous vegetable consumption and risk of type 2 diabetes: results from the Singapore Chinese health study and meta-analysis. Br J Nutr 119:1057–1067. https://doi.org/10.1017/S0007114518000119CrossRefPubMed

28.

Smith L, Shin JI, Jacob L et al (2022) Association between physical multimorbidity and sleep problems in 46 low- and middle-income countries. Maturitas 160:23–31. https://doi.org/10.1016/j.maturitas.2022.01.007CrossRefPubMed

29.

Harada G, Takeuchi D, Inai K et al (2019) Prevalence and risk factors of sleep apnoea in adult patients with CHD. Cardiol Young 29:71–77. https://doi.org/10.1017/S1047951118001853CrossRefPubMed

30.

Li J, Savransky V, Nanayakkara A et al (2007) Hyperlipidemia and lipid peroxidation are dependent on the severity of chronic intermittent hypoxia. J Appl Physiol (1985) 102:557–563. https://doi.org/10.1152/japplphysiol.01081.2006CrossRefPubMed

31.

Tveit RL, Lehmann S, Bjorvatn B (2018) Prevalence of several somatic diseases depends on the presence and severity of obstructive sleep apnea. PLoS One 13:e0192671. https://doi.org/10.1371/journal.pone.0192671CrossRefPubMedPubMedCentral

32.

He L, Biddle SJH, Lee JT et al (2021) The prevalence of multimorbidity and its association with physical activity and sleep duration in middle aged and elderly adults: a longitudinal analysis from China. Int J Behav Nutr Phys Act 18:77. https://doi.org/10.1186/s12966-021-01150-7CrossRefPubMedPubMedCentral

33.

Nicholson K, Rodrigues R, Anderson KK et al (2020) Sleep behaviours and multimorbidity occurrence in middle-aged and older adults: findings from the Canadian Longitudinal Study on Aging (CLSA). Sleep Med 75:156–162. https://doi.org/10.1016/j.sleep.2020.07.002CrossRefPubMed

34.

Savard J, Ivers H, Villa J et al (2011) Natural course of insomnia comorbid with cancer: an 18-month longitudinal study. J Clin Oncol 29:3580–3586. https://doi.org/10.1200/JCO.2010.33.2247CrossRefPubMed

35.

Budhiraja R, Parthasarathy S, Budhiraja P et al (2012) Insomnia in patients with COPD. Sleep 35:369–375. https://doi.org/10.5665/sleep.1698CrossRefPubMedPubMedCentral

36.

Unnikrishnan D, Jun J, Polotsky V (2015) Inflammation in sleep apnea: an update. Rev Endocr Metab Disord 16:25–34. https://doi.org/10.1007/s11154-014-9304-xCrossRefPubMedPubMedCentral

37.

Pathogenesis of obstructive sleep apnoea in hypertensive patients: role of fluid retention and nocturnal rostral fluid shift | Journal of Human Hypertension. https://www.nature.com/articles/jhh201494. Accessed 31 Dec 2022

38.

Nadeem R, Molnar J, Madbouly EM et al (2013) Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med 9:1003–1012. https://doi.org/10.5664/jcsm.3070CrossRefPubMedPubMedCentral

39.

Ronaldson A, Arias de la Torre J, Prina M et al (2021) Associations between physical multimorbidity patterns and common mental health disorders in middle-aged adults: a prospective analysis using data from the UK Biobank. Lancet Reg Health Eur 8:100149. https://doi.org/10.1016/j.lanepe.2021.100149CrossRefPubMedPubMedCentral

Titel: Comorbidities are associated with self-reported sleep-disordered breathing and insomnia: a cross-sectional study from China
verfasst von: Shengnan Li
Siyue Tan
Dong Liu
Ke Zhang
Yuyi Zhang
Bo Wang
Hui Zuo
Publikationsdatum: 30.06.2023
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 6/2023
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-023-02875-4

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Comorbidities are associated with self-reported sleep-disordered breathing and insomnia: a cross-sectional study from China